Deputy Chief Management Officer of the Department of Defense ADMINISTRATIVE INSTRUCTION NUMBER 0118 September 11, 2015 Incorporating Change 1, May 4, 2017 FSD, WHS SUBJECT: Civilian Employees Occupational Health and Medical Services Program References: See Enclosure 1 1. PURPOSE. In accordance with the authority in DoD Directive (DoDD) 5110.04 (Reference (a)) and DoD Instruction (DoDI) 5025.01 (Reference (b)), this administrative instruction (AI): a. Reissues DoDI 1438.5 (Reference (c)) as an AI to implement the policy requirements in section 7901 of Title 5, United States Code (Reference (d)). b. Assigns responsibilities and prescribes procedures for occupational health and medical services programs for civilian employees in facilities managed or leased by the Washington Headquarters Services (WHS) in the National Capital Region (NCR). 2. APPLICABILITY. This AI: a. Applies to civilian employees of the OSD, the Military Departments, the Office of the Chairman of the Joint Chiefs of Staff and the Joint Staff, the Combatant Commands, the Inspector General of the Department of Defense, the Defense Agencies, the DoD Field Activities, and all other organizational entities located within facilities managed or leased by WHS in the NCR (referred to collectively in this AI as the WHS-serviced Components ). This includes the Pentagon Reservation, Mark Center, and WHS-leased, General Services Administration-leased, government-owned, and other WHS-administered DoD space in the NCR. b. Does not apply to civilian employees in the Raven Rock Mountain Complex or on military installations.
3. POLICY. In accordance with Reference (a), WHS will assign responsibilities and prescribe procedures to implement the Civilian Employees Occupational Health and Medical Services Program in the NCR, as required by Reference (d). 4. RESPONSIBILITIES. See Enclosure 2. 5. PROCEDURES. See Enclosure 3. 6. RELEASABILITY. Cleared for public release. This AI is available on the Internet from the DoD Issuances Website at http://www.dtic.mil/whs/directives. 7. EFFECTIVE DATE. This AI is effective September 11, 2015. Patricia M. Young Director Washington Headquarters Services Enclosures 1. References 2. Responsibilities 3. Procedures for Civilian Employee Medical Surveillance 4. DoD NCR CEOHMSC Glossary Change 1, 05/04/2017 2
ENCLOSURE 1 REFERENCES (a) DoD Directive 5110.04, Washington Headquarters Services (WHS), March 27, 2013 (b) DoD Instruction 5025.01, DoD Issuances Program, June 6, 2014, as amended August 1, 2016, as amended (c) DoD Instruction 1438.5, Civilian Employees Occupational Health and Medical Services Program, December 4, 1997 (hereby cancelled) (d) Section 7901 of Title 5, United States Code (e) DoD Directive 4715.1E, Environment, Safety, and Occupational Health (ESOH), (f) March 19, 2005 DoD Instruction 6055.01, DoD Safety and Occupational Health (SOH) Program, October 14, 2014 (g) Administrative Instruction 83, Federal Employees Compensation Program, February 7, 2008 (h) DoD Instruction 6025.18, Privacy of Individually Identifiable Health Information in DoD Health Care Programs, December 2, 2009 (i) DoD 6025.18-R, DoD Health Information Privacy Regulation, January 24, 2003 (j) DoD Directive 5400.11, DoD Privacy Program, October 29, 2014 (k) DoD Directive 6490.02E, Comprehensive Health Surveillance, February 8, 2012, as amended (l) DoD Instruction 6000.14, DoD Patient Bill of Rights and Responsibilities in the Military Health System (MHS), September 26, 2011, as amended (m) DoD Manual 8910.01, Volume 1, DoD Information Collections Manual: Procedures for DoD Internal Information Collections, June 30, 2014, as amended (n) DoD Instruction 6055.05, Occupational and Environmental Health (OEH), November 11, 2008 (o) DoD Instruction 6055.17, DoD Installation Emergency Management (IEM) Program, January 13, 2009, as amended February 13, 2017 Change 1, 05/04/2017 3 ENCLOSURE 1
ENCLOSURE 2 RESPONSIBILITIES 1. DIRECTOR, WHS. Under the authority, direction, and control of the Deputy Chief Management Officer of the Department of Defense (DCMO) and through the Director of Administration, Office of the DCMO, the Director, WHS: a. Oversees the Civilian Employees Occupational Health and Medical Services Program. b. Ensures occupational health and medical services include: (1) Emergency medical services. (2) Occupational medical examinations and medical surveillance programs. (3) Consultation for workplace injuries and illnesses. (4) Health promotion and wellness programs. (5) DoD Installation Emergency Management Program support. (6) Employee assistance programs. (7) Preventive medicine. c. Administers the joint DoD NCR Civilian Employees Occupational Health and Medical Services Committee (CEOHMSC) to provide program oversight, as described in Enclosure 4. 2. ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS (ASD(HA)). Under the authority, direction, and control of the Under Secretary of Defense for Personnel and Readiness (USD(P&R)), and based on requirements identified by the Director, WHS, and the Pentagon Governance Council (PGC), the ASD(HA): a. Plans and provides funding for the DoD NCR civilian employees occupational health and medical services. b. Appoints the Director, DiLorenzo TRICARE Health Clinic (DTHC), to co-chair the DoD NCR CEOHMSC. c. Assigns a representative from the office of the Deputy Assistant Secretary of Defense for Health Services Policy and Oversight, Office of the ASD(HA), to serve on the CEOHMSC. Change 1, 05/04/2017 4 ENCLOSURE 2
3. DIRECTOR, DEFENSE HEALTH AGENCY (DHA). Under the authority, direction, and control of the USD(P&R) through the ASD(HA), the Director, DHA: a. Provides, primarily through the Walter Reed National Military Medical Center, all necessary occupational and health services, as requested by the Director, WHS, and the PGC and funded by the ASD(HA) in accordance with DoDD 4715.1E (Reference (e)) and this AI. b. Requires the Director, DTHC, in cooperation with the PGC, to oversee and provide civilian employees occupational health and medical services programs, in accordance with Reference (e) and paragraph 1b of this enclosure. c. Appoints a point of contact (POC) for all medical matters related to the operation of the clinic facilities in the Pentagon and Mark Center. 4. WHS-SERVICED COMPONENT HEADS. The WHS-serviced Component heads and the Director, WHS, for the Office of the Secretary of Defense: a. Identify a management POC for their respective Components to administer their occupational health programs, coordinate with DTHC to identify employees who are required to participate in medical surveillance programs, and receive reports and results of examination findings. b. In accordance with DoDI 6055.01 (Reference (f)), ensure supervisors are aware of procedures and responsibilities related to reporting employee accidents, injuries, or fatalities to their servicing human resources organization. c. Ensure that copies of all Workers Compensation forms (e.g., CA-1, Federal Employee s Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation; CA-2, Notice of Occupational Disease and Claim for Compensation; or CA-6, Official Superior s Report of Employee s Death ), all available on the Department of Labor website at http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm, that report accidents, injuries, or fatalities are forwarded promptly to the Injury Compensation Program Administrator in accordance with AI 83 (Reference (g)). d. Ensure that all reportable information is made available to facilitate agency reporting obligations in accordance with Reference (f). 5. SECRETARIES OF THE MILITARY DEPARTMENTS AND DIRECTOR OF THE JOINT STAFF. In addition to the responsibilities in section 4 of this enclosure, the Secretaries of the Military Departments and Director of the Joint Staff will appoint representatives to serve on the DoD NCR CEOHMSC. Change 1, 05/04/2017 5 ENCLOSURE 2
ENCLOSURE 3 PROCEDURES FOR CIVILIAN EMPLOYEE MEDICAL SURVEILLANCE 1. PROTECTED HEALTH INFORMATION (PHI) AND PERSONALLY IDENTIFIABLE INFORMATION (PII). WHS-serviced Component occupational health POCs will ensure all PHI and PII is collected, maintained, disseminated, and used in accordance with DoDI 6025.18 (Reference (h)), DoD 6025.18-R (Reference (i)), and DoDD 5400.11 (Reference (j)). 2. COVERAGE. WHS-serviced Component occupational health POCs will identify civilian employees requiring medical examination or surveillance as necessary in accordance with DoDD 6490.02E (Reference (k)) and DoDI 6000.14 (Reference (l)). 3. MEDICAL SURVEILLANCE SERVICES a. The DTHC will provide: (1) Pre-employment physicals, as required by position description. (2) Annual clinical examinations, as required by position description, union agreement, Reference (g), or where medical surveillance or certification is required by applicable instruction or regulation. (3) Return to duty evaluations, as requested by the WHS-serviced Component occupational health POC or his or her designee in accordance with Reference (i). Medical evaluations are recommended for employees when they return to duty from occupational injury or illness. The results of these examinations are useful in evaluating employee capabilities relative to job requirements. The medical officer will provide a written recommendation to the employee and employee s immediate supervisor for appropriate administrative action. b. The DTHC will communicate relevant findings to the WHS-serviced Component occupational health POC or his or her designee. The DTHC will report medical findings in compliance with References (i), (j), (k), and (l), Volume 1 of DoD Manual 8910.01 (Reference (m)), DoDI 6055.05 (Reference (n)), and DoDI 6055.17 (Reference (o)). Change 1, 05/04/2017 6 ENCLOSURE 3
ENCLOSURE 4 DoD NCR CEOHMSC 1. The CEOHMSC provides oversight and ensures that occupational health and medical services programs promote and maintain the physical and mental fitness of federal civilian employees who occupy the WHS-administered facilities in the NCR. The CEOHMSC will meet on a quarterly basis or more frequently on an ad hoc basis, when necessary. 2. The CEOHMSC will report to the Director, WHS, or his or her designee. 3. The DoD NCR CEOHMSC will be composed of these members or their representatives: a. Co-Chairs: Deputy Director, WHS Facilities Services Directorate (FSD); Director, DTHC. b. Deputy Assistant Secretary of Defense for Health Service Policy and Oversight, Office of the ASD(HA). c. Secretaries of the Military Departments. d. Director of the Joint Staff. e. Assistant Director for Support Services, Pentagon Force Protection Agency (PFPA). f. General Counsel, WHS and PFPA. g. Director, Standards and Compliance Division, WHS FSD. h. Director, DHA. Change 1, 05/04/2017 7 ENCLOSURE 4
GLOSSARY PART I. ABBREVIATIONS AND ACRONYMS AI ASD(HA) CEOHMSC DHA DoDD DoDI DTHC FSD NCR PFPA PGC PHI PII POC USD(P&R) WHS Administrative Instruction Assistant Secretary of Defense for Health Affairs Civilian Employees Occupational Health and Medical Services Committee Defense Health Agency DoD Directive DoD Instruction DiLorenzo TRICARE Health Clinic Facilities Services Directorate National Capital Region Pentagon Force Protection Agency Pentagon Governance Council protected health information personally identifiable information point of contact Under Secretary of Defense for Personnel and Readiness Washington Headquarters Services PART II. DEFINITIONS These terms and their definitions are for the purposes of this AI. civilian employee medical surveillance. The regular or repeated collection, analysis, and interpretation of health-related data and the dissemination of information to monitor the health of a population and to identify potential risks to health, thereby enabling timely interventions to prevent, treat, or control disease and injury. It includes occupational and environmental health surveillance and medical surveillance. NCR. The geographic area located within the boundaries of the District of Columbia; Montgomery and Prince Georges counties in the State of Maryland; Arlington, Fairfax, Loudoun, and Prince William counties and the City of Alexandria in the Commonwealth of Virginia; and all cities and other units of government within the geographic areas of such District, counties, and city. Change 1, 05/04/2017 8 GLOSSARY
occupational injury or illnesses. Injuries and illnesses that are directly associated to an event or exposure in the work environment that either caused or contributed to the resulting condition or significantly aggravated a pre-existing injury or illness. Pentagon Reservation. The area of land consisting of approximately 233 acres and improvements there, located in Arlington, Virginia, on which the Pentagon Office Building, Pentagon Emergency Response Center, classified waste destruction facility, heating and refrigeration plant, and other related facilities are located, including various areas designated for the parking of vehicles. WHS-serviced Components. OSD, the Military Departments, the Office of the Chairman of the Joint Chiefs of Staff and the Joint Staff, the Combatant Commands, the Inspector General of the Department of Defense, the Defense Agencies, the DoD Field Activities, and all other organizational entities located within facilities managed or leased by WHS in the NCR. Change 1, 05/04/2017 9 GLOSSARY